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[Are children properly classified within the scope of expert assessment to determine need for services?]
S Lange1, M Albrecht, J Dammann
1slange@rz.uni-osnabrueck.de
Insights
Assessment directives for children
Area of Science:
- Pediatric developmental milestones
- Social care legislation
- Activities of daily living (ADL) assessments
Context:
- Statutory care insurance companies in Germany issue directives for assessing children's need for care.
- These directives use age-based milestones for healthy children as a benchmark for assessing ill children.
- Accurate age benchmarks are crucial for determining the necessity of care and assistance.
Purpose:
- To compare age benchmarks in German assessment directives for children's daily life activities with technical literature.
- To compare these directive ages with retrospective data from parents of healthy children aged 1-12 years.
- To evaluate the accuracy of current assessment directives for pediatric care needs.
Summary:
- Analysis revealed discrepancies between directive ages and literature/parental reports for children's daily life activities.
- Assessment directives often set higher age expectations than observed in healthy child development or parental experience.
- This suggests potential inaccuracies in the current assessment of children requiring care.
Impact:
- Findings question the adequacy of current assessment directives for children needing care.
- Highlights a need to re-evaluate and update assessment directives based on current developmental data.
- Recommends a new representative prospective study to revise assessment benchmarks for children's care needs.
Abstract:
This project deals with assessment directives issued by the leading statutory care insurance companies to define the need for care of children at certain ages in coping with the activities of daily life specified by the German Social Legislation. The ages in question relate to healthy, normally developed children. They are used as a measure of comparison for the assessment of diseased children. Besides, they have a decisive significance in defining the need for care. Only if a child is not able to perform a certain activity, although it is meant to be able to do so at that age, can we define the need for help and assistance, i.e. care. The project is divided into two sections. 1. Comparison of age mentioned in the assessment directives for each of the daily life activities of healthy and normally developed children aged 1 to 12 years with the age mentioned in technical literature. 2. Comparison of age mentioned in the assessment directives for each ot the daily life activities of healthy and normally developed children at the age of 1 to 12 years with those mentioned in retrospective interviews with the same group of children. In the first part of the project, an analysis of the literature dealing with the subject was done. The literature included the stock of technical literature in the German language. Studying the literature, ages for children could be isolated, that could be classed with the activities of daily life mentioned in the German Social Code. These ages were compared with those in the assessment directives. In a second part of the project, 81 mothers and fathers of healthy, normally developed children aged 1 to 12 years were asked via a questionnaire. They were asked to estimate retrospectively from what age on their child had been able to perform certain activities of daily life without any help. The comparison of ages mentioned in the assessment directives with those of the analysis of literature conformed only regarding daily life activity. Regarding the other activities of daily life the age for children was set higher in the assessment directives than in the literature. Comparing the age of children in the assessment directives with the results of the questionnaires the age was also set higher in the directives than shown by the results of the questionnaires. The results of the literature analysis and the inquiry by questionnaires show that the ages mentioned in the assessment directives for an independent performance of daily life activities do not correspond to the development according to the age of healthy normally developed children aged 1 to 12 years. As a result of this project it seems to be justified to be doubtful about an adequate assessment of children who are in the need of care. Due to this reason it would be desirable to reexamine the data of the assessment directives by means of a new representative prospective study.